scholarly journals Cruciate retaining versus posterior-stabilized total knee arthroplasty: a short-term comparative study

2018 ◽  
Vol 4 (5) ◽  
pp. 726
Author(s):  
Raghav K. Suthar ◽  
Dimple R. Parekh ◽  
Shaival B. Mistry
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Posterior Stabilized ◽  
Superficial Infection ◽  
Cruciate Retaining ◽  
Knee Deformity ◽  
Subjective Score ◽  
Total Knee

<p class="abstract"><strong>Background:</strong> Total knee arthroplasty has got excellent results. Among the techniques (posterior-stabilized vs posterior cruciate retaining total knee arthroplasty) it is unclear whether one design has superior outcome over another. The purpose of the present study was to directly compare clinical and radiological outcomes of these two designs.</p><p class="abstract"><strong>Methods:</strong> A prospective study involving 36 patients who received a cruciate-retaining implant were compared to 30 patients who received posterior-stabilized prosthesis. At 3 months follow-up time clinical and radiological evaluation done and results were analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> At 3 months follow-up time mean knee society scores improved from 49.9/46.9 (objective/subjective score) points to 80.9/82.5 points in the cruciate-retaining group and from 48.2/43 (objective/subjective score) points to 80.4/80.2 points in the posterior-stabilized group. The ranges of motion was 117.2° (range, 90° to 130°) and 125.3° (range, 100° to 140°) in the cruciate-retaining and posterior-stabilized group respectively, at 3 month follow-up. One patient had post-operatively periprosthetic fracture reported after 2 weeks (treated conservatively), one had superficial infection (treated with dressing) and one patient with superfical infection required debridement.</p><p class="abstract"><strong>Conclusions:</strong> This study did not conclusively demonstrate the superiority of one knee design over the other, suggesting that the choice of implant should be based on surgeon preference, patients knee dimensions, pre-op knee deformity and existing pathology of the posterior cruciate ligament.</p>

scholarly journals Cruciate retaining versus posterior stabilized total knee arthroplasty for the treatment of valgus osteoarthritis?

2019 ◽  
Vol 7 (6_suppl4) ◽  
pp. 2325967119S0023
Author(s):  
Max Ettinger ◽  
Peter Savov ◽  
Henning Windhagen ◽  
Evelyn Mielke ◽  
Tilman Calliess
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Valgus Knee ◽  
Posterior Stabilized ◽  
Cruciate Retaining ◽  
Early Revision ◽  
Koos Score ◽  
Total Knee

Aims and Objectives: The debate of cruciate retaining (CR) versus posterior stabilized (PS) designs in total knee arthroplasty (TKA) is ongoing. With the posterior cruciate ligament retained, the TKA is supposed to function better in terms of proprioception, balance and kinematics. In contrast to that, PS designs are supposed to lead to higher degrees of flexion and a better femoral rollback. It is known, that the preoperative deformity negatively correlates with inferior results following TKA. When balancing a valgus knee, Ranawat et al. suggest to address the PCL in the first place. It is known that in 60% of valgus knees 1-2 soft tissue releases are necessary in order to achieve neutral alignment. Up to date no study exists, reporting the outcome of CR versus PS TKA in valgus knees. Thus, it was purpose of this study to evaluate the mid term outcome of CR versus PS TKA for the treatment of valgus OA in groups between 3°-6° of valgus, 7-10° of valgus and >10° of valgus. Materials and Methods: With the KOOS score as the primary endpoint, a sample size of 117 cases (78 CR and 39 PS) was needed in order to get a statistical power of 80%.Between 01-2011 and 03-2014 a total of 248 patients with a preoperative valgus >3° were treated with a CR TKA (167 cases) or a PS TKA (81 cases) of the same manufacturer (Stryker Triathlon, Stryker, Kalamazoo USA). CR patients were divided into the following groups: Preoperative valgus >3°-6°, 7°-10° and >10°. PS patients were divided into the following groups: Preoperative valgus >3°-6°, 7°-10° and >10°. The KOOS Score and the Oxford Knee score was collected at the time of follow up. For the CR and PS group failure rates and failure etiologies were analyzed. Patients demographics and were collected as well. Results: 141 patients were included into this study (97 CR and 44 PS cases). The CR group had a mean follow up of 57&#61617; weeks, the PS group had a follow up of 52&#61617;weeks. In the CR group, 11/97 (11%) patients were revised due to a.p. instability, whereas 2/44 (5%) patients were revised in the PS group due to infection or aseptic loosening. There was no difference regarding OKS and the KOOS score between the two groups. Further, there was no difference regarding patients demographics and no correlation between the BMI and the clinical outcome. Conclusion: The most important findings of this study are that the CR group showed a significant higher early revision rate, whereas the clinical mid term follow up results are equal. The CR version of the used system showed significantly higher early failure due to a.p. instability.

scholarly journals Comparison of Contact Kinematics in Posterior-Stabilized and Cruciate-Retaining Total Knee Arthroplasty at Long-Term Follow-Up

2020 ◽  
Vol 35 (1) ◽  
pp. 272-277 ◽  
Author(s):  
Jordan S. Broberg ◽  
Silvio Ndoja ◽  
Steven J. MacDonald ◽  
Brent A. Lanting ◽  
Matthew G. Teeter
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Posterior Stabilized ◽  
Cruciate Retaining ◽  
Contact Kinematics ◽  
Long Term Follow Up ◽  
Total Knee

scholarly journals Midterm Results of Cementless Total Knee Arthroplasty: A Retrospective Case Series

2018 ◽  
Vol 12 (1) ◽  
pp. 196-202 ◽  
Author(s):  
Radosław Stempin ◽  
Kacper Stempin ◽  
Wiesław Kaczmarek ◽  
Julian Dutka
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Case Series ◽  
Hardness Test ◽  
Midterm Results ◽  
Cruciate Retaining ◽  
Total Knee ◽  
Selection Of

Background: There is an ongoing debate about whether to use cementless or cemented fixation for Total Knee Arthroplasty (TKA). Objective: The study aimed to assess midterm survivorship of the Vanguard cementless system, and to demonstrate the utility of the Bone Hardness Test (BHT) for the selection of cementless fixation TKA. Methods: From September 2009 through November 2014, 123 total knee arthroplasties were completed, with cementless Vanguard Cruciate Retaining TKA in 110 knees (102 patients) and cemented Vanguard in 13 cases (12 patients). Implant fixation was based on intraoperative assessment of posterior cruciate ligament stability, bone quality, and BHT. All patients with a cementless Vanguard implant were eligible for this retrospective study. Preoperative and postoperative Knee Society Score and Western Ontario and McMaster Universities Osteoarthritis Index were obtained. Standardized standing anteroposterior and lateral radiographs were taken. Results: Three patients (4 TKAs) were lost to follow-up. The mean follow-up time was 5.5 ± 1.4 years. All scores significantly improved postoperatively. No radiographic failures were observed. Five-year implant survival, with revision of any component for any reason as an endpoint, was 97.2% (95% confidence interval, 91.7 - 99.1%). Five-year survival with revision for aseptic loosening was 100%. Only one knee required revision due to an isolated unrelated bearing exchange, and two additional knees required secondary resurfacing of the patella for retropatellar pain. Conclusion: Good midterm results were obtained with the cementless Vanguard Cruciate Retaining TKA for the treatment of osteoarthritis. The Bone Hardness Test appears to be an effective way to determine the selection of cementless TKA.

scholarly journals Range of Motion Outcomes Post Cruciate-Retaining vs Posterior Stabilized Total Knee Arthroplasty: A Retrospective Multi-Centre Cohort Study

2021 ◽  
Vol 2 (1) ◽  
pp. 22-27
Author(s):  
Oliver Emmanuel Yausep ◽  
Ifran Saleh ◽  
Adryan Tanujaya
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Posterior Stabilized ◽  
Nominal Data ◽  
Intraoperative Bleeding ◽  
Cruciate Retaining ◽  
Chi Squared ◽  
Total Knee

Background: The outcome for TKA (total knee arthroplasty) upon whether the posterior cruciate ligament is preserved with cruciate retaining (CR) prostheses or sacrificed with posterior stabilized (PS) prostheses are still debated between studies. Materials and Methods: We included a total of 144 knees operated with cemented fixed bearing primary CR or PS TKAs. Independent t-tests were conducted for the outcomes and possible confounding variables between groups where relevant, with analyses using Chi-squared tests for nominal data. Results: Operation on patients with age of lower than 65 years predicts increased intraoperative bleeding volume (p = 0.037), pre-operative range of motion (ROM) of less than 90 degrees was a predictor for better improved post-operative ROM (p 0.001) and PS prostheses is superior to CR in terms of ROM improvement (p = 0.04), however with both groups achieving similar maximum ROM (p = 0.308). Conclusion: Improvement of ROM is increased by the use of PS prostheses compared to CS prostheses, with pre-operative ROM as a possible confounding factor and the maximum ROM achieved for both prostheses being similar. Lower age of the operation is also related to increased intraoperative bleeding

Early outcomes of a modern cemented total knee arthroplasty

2021 ◽  
Vol 103-B (6 Supple A) ◽  
pp. 51-58
Author(s):  
JaeWon Yang ◽  
Nathanael D. Heckmann ◽  
Cindy R. Nahhas ◽  
Michael B. Salzano ◽  
Gregory P. Ruzich ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Aseptic Loosening ◽  
Knee Arthroplasty ◽  
Joint Infection ◽  
Posterior Stabilized ◽  
Cruciate Retaining ◽  
Primary Tkas ◽  
Total Knee ◽  
The Impact

Aims Recent total knee arthroplasty (TKA) designs have featured more anatomical morphologies and shorter tibial keels. However, several reports have raised concerns about the impact of these modifications on implant longevity. The aim of this study was to report the early performance of a modern, cemented TKA design. Methods All patients who received a primary, cemented TKA between 2012 and 2017 with a minimum two-year follow-up were included. The implant investigated features an asymmetrical tibial baseplate and shortened keel. Patient demographic details, Knee Society Scores (KSS), component alignment, and the presence of radiolucent lines at final follow-up were recorded. Kaplan-Meier analyses were performed to estimate survivorship. Results A total of 720 of 754 primary TKAs (95.5%) were included with a mean follow-up of 3.9 years (SD 1.3); 562 (78.1%) were cruciate-retaining and 158 (21.9%) were posterior-stabilized. A total of 11 (1.5%) required reoperation for periprosthetic joint infection and seven (1.0%) for aseptic tibial loosening (five cruciate-retaining, two posterior-stabilized). Loosening occurred at a mean of 3.3 years (0.9 to 6.5). There were no cases of loosening in the 33 patients who received a 14 mm × 30 mm tibial stem extension. All-cause survivorship was 96.6% at three years (95% confidence interval (CI) 95.3% to 98.0%) and 96.2% at five years (95% CI 94.8% to 97.7%). Survivorship with revision for aseptic loosening was 99.6% at three years (95% CI 99.1% to 100.0%) and 99.1% at five years (95% CI 98.4% to 99.9%). Tibial components were in significantly more varus in those with aseptic loosening (mean 3.4° (SD 3.7°) vs 1.3° (SD 2.0°); p = 0.015). There were no other differences in demographic, radiological, or surgical characteristics between revised and non-revised TKAs for aseptic loosening (p = 0.293 to 1.00). Mean KSS improved significantly from 57.3 (SD 9.5) preoperatively to 92.6 (SD 8.9) at the final follow-up (p < 0.001). Conclusion This is the largest series to date of this design of implant. At short-term follow-up, the rate of aseptic tibial loosening is not overly concerning. Further observation is required to determine if there will be an abnormal rate of loosening at mid- to long-term follow-up. Cite this article: Bone Joint J 2021;103-B(6 Supple A):51–58.

scholarly journals Double-high insert presents with worse mid-term outcomes in cruciate-retaining medial-pivotal total knee arthroplasty – a propensity score matched analysis with averaged 8-year follow-up

2021 ◽  
Author(s):  
Shuai Xiang ◽  
Yingzhen Wang ◽  
Chengyu Lv ◽  
Changyao Wang ◽  
Haining Zhang
Keyword(s):  
Total Knee Arthroplasty ◽  
Propensity Score ◽  
Knee Arthroplasty ◽  
Womac Score ◽  
Cruciate Retaining ◽  
Radiographic Outcomes ◽  
Clinical Scores ◽  
Total Knee ◽  
Knee Society Function Score

Abstract Background The aim of this study was to compare the mid-term clinical and radiographic outcomes between medial-pivotal (MP) insert and double-high (DH) insert used under cruciate-retaining condition in ADVANCE® total knee arthroplasty (TKA). Methods The follow-up was conducted for 158 consecutive patients underwent unilateral ADVANCE® TKA from January 2011 to April 2014. 84 MP inserts and 74 DH inserts were used under cruciate-retaining condition. A 1:1 propensity score matching (PSM) analysis was performed between MP insert and DH insert to compare the clinical and radiographic outcomes. Results After a 1:1 PSM, 120 patients (60 pairs) were matched between MP insert and DH insert. The baseline demographic parameters and clinical scores were comparable between the two groups. The postoperative clinical outcomes at an averaged 8-year follow-up of both groups were significantly improved. The range of motion (ROM) of DH group was better than that of MP group and equivalent Knee Society Function Score (KSFS) between the two groups was found. However, the Knee Society Score (KSS), Western Ontario and McMaster Universities Arthritis Index (WOMAC) score and Forgotten Joint Score (FJS) of MP group were found to be significantly superior than those of DH group. Comparable complication rate and revision rate were observed between the two groups. The radiographic results were also equally good between MP and DH group. Conclusions Although the mid-term clinical and radiographic outcomes of DH insert are fairly good, the clinical scores of DH group were worse than those of MP group.

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